多模态MRI影像特征与腮腺肿瘤良恶性判定的关系及病理结果对比

Relationship between multimodal MRI features and benign and malignant diagnosis of parotid tumor and comparison of pathological results

目的:探讨腮腺肿瘤患者多模态MRI影像特征及其在判定肿瘤良恶性中的应用价值。方法:将我院2017年9月—2019年1月收治的120例腮腺肿瘤患者依照病理诊断结果分为恶性组及良性组;连续采集40个期相动态增强扫描图像,采用多模态MRI检测,以病理学诊断结果作为金标准,分析多模态MRI在鉴别腮腺肿瘤良恶性中的诊断价值。结果:多形性腺瘤大多为单发,呈椭圆或者圆形,肿瘤的包膜边界清楚可见,主要为实性结节,T_(1)WI表现为等信号或稍低信号,T_(2)WI表现为混杂高信号,增强扫描明显强化。腺淋巴瘤T_(1)WI呈稍低信号或低信号;腮腺恶性肿瘤大多为单发,不规则形态,边界不清晰,信号不均匀,T_(2)WI表现为低信号,增强扫描均匀或不规则强化,伴有颈部淋巴结肿大以及周围结构的侵犯。采用多模态MRI对腮腺肿瘤患者进行扫描检查时,良性肿瘤组中MRI扫描图像呈形状规则、边缘清晰、DWI信号均匀、周围组织未受侵犯、高信号强度者占比明显高于恶性肿瘤组,且差异存在统计学意义(P<0.05)。采用多模态MRI鉴别腮腺肿瘤时其敏感度为92.31%,特异度91.18%,AUC为0.890。结论:采用腮腺多模态MRI影像判定腮腺肿瘤良恶性的敏感度及特异度均大于90%,具有较高应用价值。

Objective:To explore the multi-modal MR imaging characteristics of parotid gland tumor and its application value in judging the benign and malignant nature of tumor.Methods:From September 2017 to January 2019,120 patients with parotid gland tumors were divided into malignant group and benign group according to the pathological diagnosis results.Forty consecutive phase dynamic contrast-enhanced images were collected and detected by multimodal MRI.The pathological diagnosis results were used as the gold standard to analyze the diagnostic value of multimodal MRI in the differential diagnosis of parotid gland tumor.Results:Pleomorphic adenoma mostly presented as single,oval or round,the envelope boundary of the tumor was clearly visible,mainly solid nodules,T_(1)WI showed equal signal or slightly low signal,T_(2)WI showed mixed high signal,enhanced scan was significantly enhanced.Adenolymphoma showed slightly low signal or low signal on T_(1)WI,most of parotid malignant tumors presented single,irregular shape,unclear boundary and uneven signal,T_(2)WI showed low signal,enhanced scan showed homogeneous or irregular enhancement,accompanied by cervical lymph node enlargement and surrounding structure invasion.When the patients with parotid gland tumors were scanned by multimodal MRI,the proportion of patients with regular shape,clear edge,uniform DWI signal,undisturbed surrounding tissues and high signal intensity in benign tumor group was significantly higher than that in malignant tumor group,and the difference was statistically significant(P<0.05).The sensitivity,specificity and AUC were 92.31%,91.18%and 0.890 respectively.Conclusions:The sensitivity and specificity of multimodal MRI in the diagnosis of parotid tumors are more than 90%,which has high application value.